How should you determine whether a murmur is systolic or diastolic?

Question 1

How should you determine whether a murmur is systolic or diastolic?

Palpate the carotid pulse

Palpate the radial pulse

Judge the relative length of systole and diastole by auscultation

Correlate the murmur with a bedside heart monitor

Question 2

Common or concerning symptoms to inquire about in the General Survey and vital signs include all of the following except _________________.

changes in weight

fatigue and weakness

cough

fever and chills

Question 3

Mrs. Anderson presents with an itchy rash which is raised, and which appears and disappears in various locations. Each lesion lasts for many minutes. What most likely accounts for this rash?

Insect bite

Urticaria or hives

Psoriasis

Purpura

Question 4

Steve has just seen a 5-year-old girl who wheezes when exposed to cats. The patient s family history is positive for asthma. You think the child most likely has asthma. What have you accomplished?

You have tested your hypothesis

You have developed a plan

You have established a working diagnosis

You have created a hypothesis

Question 5

You note a painful ulcerative lesion near the medial malleolus, with accompanying hyperpigmentation. Which of the following etiologies is most likely?

Arterial insufficiency

Neuropathic ulcer

Venous insufficiency

Trauma

A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse’s priority assessments? 

Question 1

A nurse works in a private hospital and needs to administer some narcotic drugs to one of her patients. Which of the following should the nurse consider when administering narcotics to patients in a hospital setting?

A) Narcotics are banned in private settings and cannot be used.
B) Narcotics can be used in the hospital after obtaining written approval from the Joint Commission for Accreditation of Hospitals and Healthcare Organizations (JCAHO).
C) Narcotics to be used in the hospital are dispensed only with a written prescription.
D) Narcotics can be used in the hospital according to patient preferences.

Question 2

A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate?

A) The drug will decrease in effectiveness
B) The drug will increase in effectiveness
C) There will be a steady state with no anticipated changes
D) The drug will cause excessive therapeutic effects even when administered in small doses.

Question 3

A nurse is creating a plan of care for a 68-year-old woman with a recent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient’s care?

A) Incontinence, Functional, related to adverse effects of drug therapy
B) Risk for Fluid Volume Deficit related to adverse effects of drug therapy
C) Confusion, Acute, related to adverse effects of drug therapy
D) Acute Pain, Headache, related to adverse effects of drug therapy

Question 4

A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of

A) nonpharmacologic interventions combined with an exercise program.
B) drug therapy with bromocriptine (Parlodel).
C) aggressive respiratory assistance
D) no nursing action unless the patient experiences a “bad trip.”

Question 5

A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse’s priority assessments?

A) Respiratory rate, seizure activity, and electrolytes
B) Pain intensity, respiratory rate, and level of consciousness
C) Liver function studies, pain intensity, and blood glucose level
D) Respiratory rate, pain intensity, and mental status

A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider? 

Question 51

57-year-old male patient who has been prescribed doxorubicin for small-cell lung cancer is advised by the nurse to avoid taking aspirin or drugs that contain aspirin because it may

A) cause extravasation injury.

B) promote bleeding.

C) cause a radiation recall reaction.

D) cause acute nausea and vomiting.

Question 52

A 70-year-old woman is starting on an acidic drug. The nurse is aware that food and nutrient intake can affect drug excretion by changing the urinary pH. About which of the following will the nurse question the patient concerning her diet?

A) The intake of sodium

B) The amount of meat and vegetables

C) The use of grapefruit

D) The intake of foods high in protein

Question 53

A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that

A) she will report this to the physician immediately.

B) the drug is not going to work for her and the medication needs to be changed.

C) optimum relief of anxiety usually occurs after 3 to 4 weeks of treatment.

D) it may take up to 6 months for the drug to relieve her anxiety.

Question 54

A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?

A) Dietary habits

B) Work environment

C) Typical daily fluid intake

D) Ethnicity

Question 55

A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is

A) headache.

B) irritability.

C) dry mouth.

D) heart palpitations.

A patient has been prescribed an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?  

 

Part 1 

Question 1

A nurse works in a private hospital and needs to administer some narcotic drugs to one of her patients. Which of the following should the nurse consider when administering narcotics to patients in a hospital setting?

A) Narcotics are banned in private settings and cannot be used.
B) Narcotics can be used in the hospital after obtaining written approval from the Joint Commission for Accreditation of Hospitals and Healthcare Organizations (JCAHO).
C) Narcotics to be used in the hospital are dispensed only with a written prescription.
D) Narcotics can be used in the hospital according to patient preferences.

Question 2

A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate?

A) The drug will decrease in effectiveness
B) The drug will increase in effectiveness
C) There will be a steady state with no anticipated changes
D) The drug will cause excessive therapeutic effects even when administered in small doses.

Question 3

A nurse is creating a plan of care for a 68-year-old woman with a recent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient’s care?

A) Incontinence, Functional, related to adverse effects of drug therapy
B) Risk for Fluid Volume Deficit related to adverse effects of drug therapy
C) Confusion, Acute, related to adverse effects of drug therapy
D) Acute Pain, Headache, related to adverse effects of drug therapy

Question 4

A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of

A) nonpharmacologic interventions combined with an exercise program.
B) drug therapy with bromocriptine (Parlodel).
C) aggressive respiratory assistance
D) no nursing action unless the patient experiences a “bad trip.”

Question 5

A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse’s priority assessments?

A) Respiratory rate, seizure activity, and electrolytes
B) Pain intensity, respiratory rate, and level of consciousness
C) Liver function studies, pain intensity, and blood glucose level
D) Respiratory rate, pain intensity, and mental status

Question 6

A patient has been prescribed an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?

A) Giving the drug with food in order to delay absorption
B) Administering the drug in small, frequent doses
C) Limiting the patient’s protein intake and encouraging fluids
D) Administering the drug intravenously rather than orally

Which of the following is a diagnostic label that is listed in the Diagnostic and Statistical Manual IV-TR?

Question 1

Which of the following is a diagnostic label that is listed in the Diagnostic and Statistical Manual IV-TR?

Premenstrual dysphoric disorder

Premenstrual magnification

Dysmenorrhea

Premenstrual syndrome

Question 2

About half of all pregnancies in the United States are unintended and occur most frequently in women who:

Are married or divorced

Have finished high school

Are between the ages of 18 and 24

Are members of the majority group

Question 3

What is one factor that can reduce the risk for the development of ovarian cancer?

Multiple pregnancies

Transvaginal ultrasounds

Identification of recurrence

Weight loss

Question 4

What percentage of toxic shock syndrome cases are related to menses?

50%

25%

75%

90%

Question 5

Tubal sterilization for women who have completed their families is highly effective, but there are disadvantages such as:

Women are less likely to use condoms or return for health services.

There is a decreased risk of ovarian cancer and pelvic inflammatory disease.

There is a high likelihood of complications and side effects.

The surgery is not covered by insurance

Why do adolescents have the highest risk of developing pelvic inflammatory disease (PID)?

Question 1

How can liver and renal diseases result in abnormal uterine bleeding (AUB)?

They cause an imbalance in platelet aggregation.

They result in an inability to adequately clear estrogen from the body.

They cause thyroid dysfunction, which leads to bleeding abnormalities.

They result in elevated prolactin levels, which lead to bleeding abnormalities

Question 2

What is now thought to be the most important causative agent in cervical cancer?

PCOS

Vulvar cancer

Herpes simplex

HPV

Question 3

An initial or primary genital herpes infection characteristically lasts about:

1 week
3 weeks

1 month

6 weeks

Question 4

Which contraceptive methods have inherent failure rates?

None

Some

All

All except sterilization

Question 5

Why do adolescents have the highest risk of developing pelvic inflammatory disease (PID)?

They have the highest risk for bacterial vaginosis.

They are the least at risk for developing other STIs.

They are the most sexually active.

They have decreased immunity to infectious organisms

Who should be screened regularly for STIs?

Question 1

Who should be screened regularly for STIs?

Women who are sexually active

bisexual men

Pregnant women

Gay men

Question 2

All of the following diagnostic testing and procedures are now infrequently performed in clinical practice except:

Hysterosalpingogram

Sperm penetration assay

The postcoital test (PCT)

Endometrial biopsy (EMB)

Question 3

Which organism causes 90% of vulvovaginal candidiasis episodes in women?

Candida tropicalis

Candida albicans

Candida glabrata

Candida krusei

Question 4

Which one of the following statements about the subdermal progestin implant is false?

It is associated with the development of benign follicular cysts.

After removal, its contraceptive effects last 10 more months on average.

Based on worldwide data, it appears to be as safe as other progestin-only methods.

The shortage of research due to its only recent availability is a possible disadvantage

Question 5

What can bacterial vaginosis lead to?

Pelvic inflammatory disease

Benign ovarian cyst

Leiomyomas
Uterine prolapse Endometrial

While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process?

QUESTION 1

A noncompliant patient states, “Why do you want me to put this poison in my body?” Identify the best response made by the psychiatric-mental health nurse practitioner (PMHNP).

A. “You have to take your medication to become stable.”

B.”Most medications will increase the number of neurotransmitters that you already have in the brain.”

C.”Most medications used in treatment are either increasing or decreasing neurotransmitters that your body already has.”

D.”Why do you believe that your medication is poison?”

QUESTION 2

Which statement about neurotransmitters and medications is true?

A. Natural neurotransmitters such as endorphins have been discovered after the development of medications.

B. Some medications were developed after the discovery and known action of the neurotransmitters in the brain.

C. Neurotransmitters receive messages from most medications.

D. The neurotransmitter serotonin is directly linked to depression. Following this discovery, the antidepressant Prozac was developed.

QUESTION 3

When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be:

A. “In an extreme case such as yours, more than one medication is often needed.”

B. “Due to the ineffectiveness of your current medication, we need to try something else that can possibly potentiate its effects.

C. “Medications are often specific to the neurotransmitter(s) they are affecting and, due to more than one neurotransmitter involvement, it is often necessary to use more than one medication to improve symptoms.”

D. “I understand your concern. We can discontinue your current medication and switch to a different one that may better manage your symptoms.”

QUESTION 4

During gene expression, what must occur prior to a gene being expressed?

A. Transcription factor must bind to the regulatory region within the cell’s nucleus.

B. RNA must be converted to mRNA.

C. The coding region must separate from the regulatory region. This is wrong

D. RNA polymerase must inhibit the process of changing RNA to mRNA.

QUESTION 5

While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process?

A. Genes impact neuron functioning directly.

B. Changes made to proteins lead to changes in behavior.

C. Neurons are able to impact protein synthesis.

D. Genes impact the DNA of a cell, leading to changes in behavior.

Which statement made by a student indicates the healthcare professional needs to describe the pericardium again?

Question 1

Which statement made by a student indicates the healthcare professional needs to describe the pericardium again?

a. The pericardium is a double-walled membranous sac that encloses the heart.
b. It is made up of connective tissue and a surface layer of squamous cells.
c. The pericardium protects the heart against infection and inflammation from the
lungs and pleural space.
d. It contains pain and mechanoreceptors that can elicit reflex changes in blood
pressure and heart rate.

Question 2

A healthcare professional is assessing a child who has complete trisomy of the twenty-first chromosome. What findings does the professional relate to this condition?

a. An IQ of 25 to 70, low nasal bridge, protruding tongue, and flat, low-set ears
b. circumoral cyanosis, edema of the feet, short stature, and mental slowness
c. Widely spaced nipples, reduced carrying angle at the elbow,a nd sparse body hair
d. high-pitched voice, tall stature, gynecomastia, and an IQ of 60 to 90

Question 3

The data reporting that sickle cell disease affects approximately 1 in 600 American blacks is an example of which concept?

a. Incidence
b. Prevalence

c. Ratio
d. Risk

Question 4

Vaccinations are able to provide protection against certain microorganisms because of what?

a. Strong response from IgM
b. Level of protection provided by IgG
c. Rapid response from IgA
d. Memory cells for IgE

Question 5

Renal failure is the most common cause of which type of hyperparathyroidism?

a. Primary
b. Secondary
c. Exogenous
d. Inflammatory

Which part of the information contained in the patient’s record may be used in court?

Question 1

In counseling a client regarding nutrition education, you explain that linoleic acid, a major fatty acid, is thought to be essential for:

a. glycogen storage in the liver.

b. normal growth and development.

c. myocardial cell function.

d. building and maintaining tissues.

Question 2

The term denoting the caregiver’s need to do no harm to the patient is:

a. Deontologic imperative

b. Nonmaleficence

c. Beneficence

d. Autonomy

e. Utilitarianism

Question 3

Before performing an abdominal examination, the examiner should:

a. ascertain the patient’s HIV status.

b. have the patient empty his or her bladder.

c. don double gloves.

d. completely disrobe the patient.

Question 4

Which part of the information contained in the patient’s record may be used in court?

a. Subjective information only

b. Objective information only

c. Diagnostic information only

d. All information

Question 5

To perform the Rinne test, place the tuning fork on the:

a. top of the head.

b. mastoid bone.

c. forehead.

d. preauricular area.